The firms behind your dentist
Observations on health service
Imagine that the governors of Eton, Harrow or Winchester started buying up comprehensive schools and then writing to parents to inform them that, henceforth, they would have to pay hefty fees for their children's education. Something very similar has happened to the NHS dentistry service and it explains why 300 people in Scarborough recently queued for hours in the bitter cold to register with a newly arrived NHS dentist.
The media blamed the problem highlighted by the Scarborough queue on the shortage of qualified dentists and "abysmal" NHS payment rates - which translate as an annual salary of about £50,000 after expenses. There was not a word on how private dental chains have contributed to a situation in which less than half the population can now go to an NHS dentist.
Most NHS dentists, with the exception of 2,000 or so salaried "community" dentists and those working in hospitals, have never been employed directly by the state. But practices that previously offered NHS treatment have been taken over by the private chains in what is, to all intents and purposes, a privatisation as sweeping and as damaging as any we have lived through in the past 20 years.
When I revealed in the NS last August how the largest chain, Oasis Healthcare plc, was converting NHS practices to private-only treatment, its chief executive, Malcolm Hughes, wrote to deny that the company had anything to do with "the parlous state" of NHS dentistry. It is not an assertion with which NHS patients registered at the Park Lodge surgery in Brackley, Northamptonshire, would concur. In November, a year after Oasis had taken over, they were informed in writing of the company's "new approach to your dentistry". Claiming that providing dentistry to the highest of "clinical standards" was "increasingly difficult under the current structure of the NHS", Oasis offered two options: membership of "Essentials", a monthly payment scheme that includes two check-ups per year and X-rays, but only a 20 per cent discount on additional treatments; and "pay as you go" treatment with, for example, charges of £90 for a large metal filling that would cost £19 on the NHS.
In an October 2002 interview with the Wall Street Transcript, Hughes was more candid. "One of our key strategic objectives is to introduce increasing elements of private treatments in all of our practices," he said. Oasis's chairman, Ron Trenter, has boasted of how non-NHS care accounts for an increasing proportion of turnover. We should not be surprised. As a public limited company, Oasis exists to make maximum profits for its shareholders. That inevitably leads to an emphasis on lucrative private work at the expense of the low-cost, basic dental care that millions require and, by virtue of their taxes and national insurance contributions, surely have a right to expect.